Individual
CHITRADEVI CC WIDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT; LPC
Contact information
Practice address
8080 MOORSBRIDGE RD STE 102, PORTAGE, MI 49024-4422
(616) 920-1586
Mailing address
1656 BARNSLEY CT, LOWELL, MI 49331-8677
(616) 780-3604
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401020223
MI
106H00000X
Marriage & Family Therapist
Primary
4101007012
MI
Other
Enumeration date
06/13/2018
Last updated
02/10/2025
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